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Tramadol, metformin with CKD 3b
I'm posting this in this forum because I'm most concerned with kidney problems. I have some sensory nerve pain that has not eased for some months and as I cannot take Ibuprofen and the like, I wanted to reduce the inflammation that is present and ask the doc if I could take a drug the name of which escapes me at the moment, but he said due to the kidney problem, no. He then prescribed Tramadol at just minimum dosage three times a day as needed for pain. When I picked it up this afternoon the pharmacist came over and cautioned me not to take it within 4 to 6 hours of taking metformin. This makes it rather difficult to decide when to take what. However, an internet search does not show any problems with doing so. What do you think?
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Stage 3B is a very cautionary stage of CKD, unfortunately. First, if I recall correctly, Metformin should be avoided if your eGFR is getting close to 30. You did not mention your A1C. A Mayo doc a while back sent me to the pharmacist to see if there are any interactions among the drugs being taken, so the pharmacist plays a very critical role. But the answer lies among your PCP, endocrinologist, or nephrologist. This is the time to consider an alternative to Metformin or a lower dose, if there is one in your particular case with your endocrinologist, in my opinion. Lastly, you did not say what kind of doc prescribed the nerve pain medication, but I am assuming it was a neurologist.
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4 ReactionsAlso, nerve pain could be the result of your Diabetes.
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3 Reactions@cekkk Trust your pharmacist! They are bastions of information, and have saved many a life in watching the interactions of medications and conditions.
Ginger
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2 ReactionsThat's my inclination but since it makes it almost impossible to take both medications in a 24-hour period and still get some sleep, I am looking for a confirmation.
@cekkk
@gingerw
Internet search vs. a pharmacist, the pharmacist wins by a knockout. Your "confirmation" is to take that information to your doc for a decision. I don't believe anyone in this forum can give you "confirmation." For many docs these days, a patient portal works wonders.
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2 ReactionsBe careful with TRamadol. I took just half a pill at night for pain and to sleep. So get a second opinion for sure. The pill seemed to help but is an Opiate, a mild one. Be sure you are managed often with the doctor. I is not a strong med but does seem to take the edge off of my scar tissue pain. I think it is the mildest pain med to take. Check it out with Doctor. Take care, BB
I was one of the lucky folks to be among the very first China virus patients. Down for about 4 weeks with no memory of it, but when I got up and sat in my recliner, I felt pretty good. The next morning as it turned out my perineal nerve had crashed, and so I have drop foot. At the time a surgeon saw no connection, but now if you Google it you will find it's not common, but certainly not unheard of. And so in an attempt to alleviate the pain that accompanied it I was prescribed three different opiates over the course of a few months, one of them being Tramadol and the other two being stronger. None helped at all, and so I only took two or three of each if I recall correctly, certainly not much more than that. So I'm not unfamiliar with the drug.
the difference here is that it helps tremendously with this hip pain I have as well as the meralgia peresthetica pain. For about 3 days this week I took a 50mg at 2 in the afternoon and about 2:00 in the mornings. They really did the trick, but I don't like getting hooked on things like that, mild as it is. So I skipped one at 2:00 a.m. and felt it. That made me want to take more instantly, which is how people get hooked. So I think I will just go with one a day, that being around 2:00 a.m., and see how that goes for a while. I'm a bit surprised that I was allowed three a day as necessary for pain.
@cekkk
Last word! I can understand the immense problems you are now having with pain. But also consider that this medication over the long term may have a profound effect on both your overall health as well as your kidneys. It is addictive, and somewhat kidney friendly in "mild" doses. So in my opinion, a place like the Mayo Clinic might be able to assess both pain and kidney issues. My wife, the bionic woman. has 13 screws in her back with 6 or 7 major back surgeries, and is fused from her lower back to her neck. She got relief by attending a 3 week pain management program at Mayo. There are some sensible alternatives to your pain. Also, you may wish to consider any suggestions from your nephrologist relative to this matter before deciding your own self-medicating couse of action.
Well, as I had hoped, the pain has not totally resolved but it's nothing more than mild discomfort. When they ask you your pain level, that horrible question about 1 to 10, I'm going to give it a three. I can live with that without even acetaminophen. I feel very fortunate right now.